Digital Serious Games in Healthcare Management: Comparative Analysis and Design Recommendations

Abstract

Introduction Digital serious games (DSGs) enable healthcare management students to safely navigate the systemic complexities of the sector. However, domain-specific comparative frameworks remain scarce. This study addresses three research questions (RQs): (RQ1) What comparative characteristics can be identified for the analysis of serious games in healthcare management? (RQ2) What similarities and differences emerge between the serious games based on these characteristics? and (RQ3) Which recommendations can be derived for the design of DSGs for teaching? To address RQ1, a literature review across four databases identified five sources describing game characteristics, design principles, and pedagogical principles. Following a relevance assessment by five researchers, the identified characteristics were synthesized into a comparison matrix comprising five clusters: formal game structure and interaction; learning objectives (LOs) and measurability of results; game rules, game dynamics, and decision-making structures; resources and game environments; and aesthetic aspects and didactics. To address RQ2, the matrix was applied to five healthcare management DSGs. The analysis drew on publicly available materials, demo versions, structured interviews with providers or experts, and supplementary provider materials. Based on the comparative findings, competency-oriented design recommendations (DRs) were derived to address RQ3. Results The comparison revealed several recurring characteristics across the analyzed DSGs. Considerable variation was identified in player interaction, game duration, strategic flexibility, feedback mechanisms, and the representation of healthcare-specific complexity. Based on these findings, ten DRs were developed, emphasizing multi-role structures, LO-aligned game mechanics and feedback, flexible strategic decision-making, multidimensional performance indicators, explicit resource constraints, increasing complexity, and risk-free experimentation. Discussion The findings indicate that competency-oriented DSG design requires alignment between LOs, game mechanics, decision structures, and feedback mechanisms. However, the study was limited to five specialized DSGs and examined design characteristics rather than learner experiences or effectiveness. Future studies should assess the effects of the proposed DRs on learning outcomes, competency development, strategic decision-making, and learner engagement. The study provides an initial, literature-informed comparison matrix and ten provisional DRs for competency-oriented DSGs in healthcare management. The DRs offer a basis for developing future learning environments that reflect the specific complexity of healthcare management.